Shoulder synovial sarcoma radical excision with pedicled inverted pectoralis major flap.

Synovial sarcoma, a rare soft tissue malignancy, predominantly affects adolescents and young adults, with a predilection for extremities. We present the case of a 19-year-old woman with a rapidly growing left shoulder synovial sarcoma, initially managed with neoadjuvant chemotherapy to reduce tumor size. Subsequently, she underwent radical surgical resection, necessitating complex anatomical dissection due to tumor involvement extending into the coracoid and deltoid. Given limitations in current literature regarding reconstructive options for shoulder defects following sarcoma resection, the use of a pedicled pectoralis major flap demonstrates feasibility and functional outcomes.